Probiotic treatment with Probioflora in patients with predicted severe acute pancreatitis without organ failure |
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| Authors: | M.C. van Baal P. Kohout M.G. Besselink H.C. van Santvoort Z. Benes R. Zazula G.T. Rijkers H.G. Gooszen |
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| Affiliation: | 1. Dept. Operating Room/Evidence Based Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, HP 690, 6500 MB Nijmegen, The Netherlands;2. Dept. of Internal Medicine, Faculty Thomayer''s Hospital, Prague, Czech Republic;3. Dept. of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands;4. Dept. of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands;5. Dept. of Anesthesiology and Intensive Care, Faculty Thomayer''s Hospital, Prague, Czech Republic;1. Department of Radiation Oncology, Baskent University Adana Medical Faculty, Kisla Saglik Yerleskesi 01120, Adana, Turkey;2. Department of Nuclear Medicine, Baskent University, Adana Medical Faculty, Kisla Saglik Yerleskesi,01120 Adana, Turkey;1. Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London Institute for Liver and Digestive Health, Hampstead, London, UK;2. Department of Gastroenterology and Clinical Nutrition Addenbrooke''s Hospital, Cambridge, UK;3. Department of Internal Medicine Thomayer Hospital, Prague, Czech Republic;4. Division of Gastroenterology, Department of Medicine, Erlangen University Hospital, Erlangen, Germany;5. Gastrointestinal and Liver services Ipswich Hospital, Ipswich, UK;6. Department of Gastroenterology, Worcestershire Acute Hospital, Worcester, UK;7. Department of Gastroenterology, University Hospital of Ghent, Ghent, Belgium;8. Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK;9. Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK;10. Department of Gastroenterology and Hepatology, University Hospitals of Derby and Burton, Derby, UK;11. Department of Gastroenterology Sandwell and West Birmingham Hospitals, Lyndon, West Bromwich, West Midlands, UK;12. Department of Gastroenterology, University Hospitals Birmingham, Birmingham, UK;13. Gastrointestinal and Liver Services, Maidstone and Tunbridge Wells Hospital, Maidstone and Pembury, UK;14. Department of Gastroenterology and Hepatology, North Bristol Trust, Bristol, UK;15. Department of Gastroenterology, Colchester General Hospital, Colchester, UK;1. Third Faculty of Medicine, Charles University, Prague, Czech Republic;2. Department of Cardiology, University Hospital Kralovske Vinohrady, Prague, Czech Republic;3. The Burn Center Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic;1. Institute of Clinical Biochemistry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic;2. Department of Anaesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic;3. Department of Internal Medicine, Nutrition and Dietetic Center, Thomayer University Hospital, Prague, Czech Republic;4. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States |
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| Abstract: | BackgroundWe previously demonstrated that probiotic prophylaxis, in patients with predicted severe pancreatitis, did not prevent infectious complications but unexpectedly increased the risk of bowel ischemia and mortality. The suggestion that these negative findings are only observed in the presence of organ failure at the start of probiotic treatment has not been confirmed.MethodsIn a retrospective analysis, all patients with predicted severe acute pancreatitis without initial organ failure admitted to a medium care facility of a teaching hospital in Prague from January 2003 to December 2010 were included. All patients routinely received probiotic treatment with Probioflora. Total parenteral nutrition (TPN) was routinely started and shifted toward total enteral nutrition. Infectious complications, mortality and the incidence of bowel ischemia were recorded.Results99 consecutive patients, mean age 56 years, were included. Infectious complications occurred in 42 patients (42%), consisting of bacteremia (n = 40), pneumonia (n = 11) and infected necrosis (n = 11). Bowel ischemia was detected in two patients (2%). Overall mortality was 8%.ConclusionIn this retrospective study no apparent positive or negative impact of probiotic treatment with Probioflora was demonstrated when administered to patients with predicted severe acute pancreatitis without initial organ failure. |
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